Risk Management Analyst

Hackensack Meridian Health•Red Bank, NJ

13h

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Risk Management Analyst (RMA) is responsible for investigating risk management events, reviewing and analyzing events in the ONElink event reporting system, assisting with proactive risk management educational initiatives, working on various insurance matters, as well as assisting with claims and litigation matters on a day-to-day basis for the various lines of coverage for multiple sites within the Hackensack Meridian Health Care System. The RMA shall be responsible for legal research, discovery requests, and maintenance of files and statistical reports. The RMA shall work closely with internal and external counsel, the medical claims TPA, and insurance broker representatives. This position interacts with all levels in the organization along with the Enterprise Risk Management team toward the goal of improving safe and trusted healthcare. This position reports to the Director, Enterprise Risk Management.

Requirements

Minimum of Associates degree in Business, Insurance or related field or at least 5 years of related work experience in Risk, Paralegal, Insurance, or other related field
Proficient in Google Suite
Strong analytical and communication skills
Knowledge of legal and medical terminology
Excellent technological skills and organizational skills

Nice To Haves

A minimum of 1 to 3 years of experience in risk management, claims, and/or insurance experience is preferred.
Experience working with Insurance Brokers and representatives preferred.

Responsibilities

Investigates risks involving actual or potential injury to patients, visitors and team members
Assists with the review, investigation, follow up and closure of ONElink event reports
Prepares and provides statistical data, graphs and various other reports from the ONElink system/other systems for Enterprise Risk Management and other ad hoc requests; presents and explains relevant trends, data, and outcomes to a variety of audiences.
Makes appropriate referrals to Managers, Internal Quality Improvement teams, Peer Review Committees for appropriate follow-up to reduce risk of recurrence.
Responsible for additions and deletions of team member access and updates in the ONElink system
Assists in the process of accepting Subpoenas, and Summonses and Complaints
Investigates and analyzes claims/litigation and potential claims upon receipt.
Obtains and sequesters evidence
Obtains visit history and pertinent medical records
Notifies the liability insurance carrier of actual and potential claims
Obtains insurance information and partners with insurance team to determine coverage analysis
Processes claims with the appropriate carrier(s) and broker within policy period
Obtains coverage determinations, and partners with the risk leader to resolve unfavorable determinations
Coordinates day-to day discovery (document production, interrogatories, scheduling interviews and depositions)
Maintaining a positive working relationship with the hospital's professional and general liability insurance carrier and general counsel.
Working in coordination with the Director of Risk Management reply to requests from the hospital's legal counsel.
Obtains reimbursement from carriers as appropriate on first party claims (eg., auto and property)
Maintains current knowledge of status of all claims and litigation matters and keeps Risk Management leaders/team apprised of changes
Performs legal research as needed
Keeps abreast of healthcare risk management issues, assisting with implementation of new or revised guidelines and practices
Maintains the confidentiality and integrity of all information encountered during work activities.
Audits expenses and processes payments as needed
Maintains up-to-date claims run at all times and updates relevant parties on a quarterly basis and as needed
Maintains appropriately organized litigation files; including electronic and paper claim files; Prepares materials for quarter claim and steering committee meetings
Acts as a liaison with insurance brokers for requests from various department
Assists the Corporate Insurance Department with the professional liability insurance coverage process which includes collaboration with the Medical Staff Office, Human Resources and our insurance broker
Assists Corporate Insurance Department with the Due Diligence process and works with Physician Enterprise to assure appropriate documentation is received and reviewed
Notifies insurance broker of terminations/resignations of healthcare providers
Investigates all incidents related to vehicle and property claims in conjunction with insurance manager
Receives and investigates recall reports of medical device and product problems in collaboration with the Purchasing Dept
Represents the Enterprise Risk Management Department on various medical center committees as assigned
Participates in training of team members and in-services provided by the Enterprise Risk Management team
Adheres to HMH Organizational competencies and standards of behavior
Must work independently with general guidance on a wide variety of special projects
All other duties and projects as assigned to assist the Enterprise Risk Management Department to maintain daily activities of the departments.